Visage Imaging CEO David Chambers: On the Future of Health Care IT

Earlier this year, Pro Medicus Ltd., the Australia-based RIS provider, acquired Visage Imaging. ImagingBiz.com spoke with David Chambers, CEO of Pro Medicus Ltd. and Visage Imaging on the history of the company, details of the acquisition, and the health care IT landscape in the land down under.

“Health care (along with many facets of the delivery of that care) is shifting away from hospitals over time. This is why the golden chalice of health care informatics is to provide solutions that can span, and interoperate across, the patient’s continuum of care.” --David Chambers

ImagingBiz: Tell us about the history of Pro Medicus. Where did the company begin, and how did it get to be the diversified informatics company that it is today? Chambers: Pro Medicus started in 1984 with a medical practice-management system that has evolved into a sophisticated RIS servicing more than 70% of the Australian private-radiology market. The year 2000 was a turning point for the company. It launched an Internet-based e-health network that now services over 27,000 primary care physicians and listed the company on the Australian Stock Exchange, where we currently have a market capitalization of approximately $75 million (Australian). In 2001, we commenced a journey into the world of integrating RIS with PACS with a leading integration with Agfa. Today, this has expanded to integrations with other leading PACS companies and operations in the United States, Canada, Australia, the United Kingdom, and (with our recent acquisition of Visage Imaging) Europe. Our mission is to help our clients deliver first-rate patient care by enhancing and streamlining processes in the clinical and medical-practice setting. We do this by providing products and services that combine speed, scalability, stability, and smarts to help eliminate administrative tasks and workarounds, optimize the efficiency of clinical and administrative staff, and maximize profits. Everything we do is about providing seamless, integrated solutions in medical IT. For my part, I had more than 20 years’ experience in health care, and after a successful three-year stint as vice president of a tier-one PACS provider in the United States, I returned to Australia to take up the role of CEO of Pro Medicus in late 2007. ImagingBiz: Why did Pro Medicus make this acquisition? How does Visage’s enterprise visualization software fit into your vision of where imaging informatics is going? Chambers: Although our product had been successfully installed at more than 400 imaging centers worldwide, with integrations with a number of leading PACS companies, we could see a revolution occurring that was threatening the success of our clients’ investments in the RIS/PACS concept. The revolution has been caused by the new multidetector CT scanners and the amazing possibilities that they provide for advanced visualisation. What we realized was that most of the PACS companies had architectures that never anticipated the data volumes created by these scanners. Basically, data volumes are growing at a vastly quicker rate than networks or databases can cope with, so clients who were delighted with their RIS/PACS investments were finding them tested to the limit once new scanners were purchased. Visage has a fabulous product that solves this dilemma and allows us to deliver additional life to existing PACS, as well as significant additional functionality. This proposition excited us and fit with our goal of providing value to our clients. We are also better able to service our clients with a broader portfolio of capabilities, a global footprint, and an ability to address new clients in the large-hospital and enterprise market space. Visage Imaging’s 3D visualization product allows CT and MRI images to be reconstructed in 3D. We see it as the next wave in radiology technology. The huge advantage of the Visage product in this space is its use of thin-client distribution technology, which means 3D images can be accessed in seconds on virtually any PC without requiring the enormous amounts of computer and network memory that most current systems require. Visage is one of only several companies that currently have this technology commercialized. We believe that the trend toward volume reading will only increase as the logistics of dealing with the massive datasets are solved by companies such as ours unleashing the amazing potential of 3D and 4D image visualization. ImagingBiz: Does operating in Australia’s single-payor health care system inform your product development in any way? What can you tell us about the potential impact of such a system on the practice of radiology in the United States? Chambers: What the Australian marketplace has informed us of is the architecture and the economic drivers that best fit large groups of imaging centers and hospitals. There is far more consolidation in the Australian market, and we have clients operating with more than 100 imaging centers and hospitals supported from one database. Inherent in our design are speed and scalability for such large groups, which, of course, is also of benefit for smaller players. We do believe that the single-payor systems favor groups that are of larger scale, and this experience is, we believe, applicable to what may occur in the United States in the future. On the other hand, all our systems have been adapted to the US environment, so multiple-payor requirements are already satisfied and built in, and they cause no problem for us at all. ImagingBiz: What is the status of health IT integration in Australia, and how does that compare with the fragmented health care IT landscape in the United States? What are the primary obstacles to complete interoperability among health care providers, in your opinion? Chambers: Heath care IT in Australia is well advanced in most respects, although the implementation of electronic medical records has been somewhat hindered by privacy concerns. Pro Medicus products have been designed for use across the full continuum of care, from referring physicians’ requests through radiology and back again to the surgeons, general practitioners, and allied health professionals. In this respect, they are truly turnkey. The company’s products are well suited to the future of the United States, with RIS and practice-management solutions, fully integrated digital radiology (PACS), and e-health applications, plus a suite of services that provide a seamless, scalable, fully integrated IT environment for health care professionals. I am of the view that advances in technology, both from clinical and IT standpoints, have great impetus, and the adoption of these technologies will continue more or less unabated. The problems lie more in the area of interoperability, and the hindrance is often the lack of adherence to standards and frameworks for integration, interoperability, and health care IT transparency. No single vendor in the United States today has the ability to share data in a transparent manner, enabling clinicians across the health care enterprise to view patient data, in every sense, when and where they want them. Our vision is that we will increasingly find ways both to participate in and to shape this process, which is gradually building more forward momentum. ImagingBiz: What are Pro Medicus’ offerings in terms of practice-management solutions, and how are they adding value to radiology practices here and abroad? Chambers: We believe successful management and operation of imaging centers and hospitals of small to medium size depend on providing supportive, stable products and services that allow easy, rapid access to data and smooth system operation and management. These products and services have multisite or multidepartment scalability and include productivity tools for radiologists and clinicians, including workflow tracking. They enable users to report, in real time, on key business metrics and to conduct efficient, informative communication with referring physicians. Ultimately, it's about giving our clients what they need to work better, to grow more intelligently, to be more supported, and to provide better, more successful patient care. Our Practice Analysis technology is an interactive marketing and business-analysis tool that provides immediate insights into the state of a practice. It allows users quickly and easily to analyze and graph many aspects of practice performance. Areas such as referrals, revenue, and productivity can be assessed in order to increase revenue and address problem areas. Queries can also be filed and sorted by referring physician, modality, facility, or physician specialty. Automated report generation and distribution supports you by speeding up the turnaround process to referrers and making the process more efficient, thereby enhancing the experience of patients and their perception of your practice. ImagingBiz: As you undergo the integration of Visage into the Pro Medicus suite, how will Visage customers benefit? Chambers: Pro Medicus and Visage Imaging have combined their expertise and strengths to create solutions that are further enhanced to meet our existing customers’ health care IT and imaging-specialty needs. The union of both entities provides a broader range of product offerings and better workflow under the Visage brand, combined with top-tier support. We believe this means our customers’ investments are protected and their current and future needs will continue to be met. This acquisition provides a unique opportunity to leverage synergies between our markets and products. The alliance of Pro Medicus and Visage Imaging translates to more efficient diagnostic workflow, to advanced visualization, and to practice management and enterprise image management being fully integrated and taken to the next level. Health care (along with many facets of the delivery of that care) is shifting away from hospitals over time. This is why the golden chalice of health care informatics is to provide solutions that can span, and interoperate across, the patient’s continuum of care. This means connecting all sourced clinical data, from the general practitioner to the specialist and from the clinic to the acute setting. Bridging these environments is a daunting task for some vendors, but could again be an opportunity for Pro Medicus to bring its Australian experience to the forefront in the United States and Europe.